While some members of Congress with a medical background prefer to be addressed as "Doctor" (most notably former Senate Majority LeaderBill Frist),[3] Simpson does not insist that he be referred to as Dr. Simpson, preferring to simply go by Congressman or Mr. Simpson.

In the 111th United States Congress Simpson became the Ranking Member on the Interior, Environment, and Related Agencies Appropriations Subcommittee. Upon assuming this position, and the subsequent chairmanship of the subcommittee, Mr. Simpson is considered a "Cardinal" (a term applied to the chairmen or ranking members of the Appropriations Subcommittees) within the House Republican Caucus. He also serves as the small state representative on the 33-member House Republican Steering Committee.[4] Known as the "committee of committees", the Steering Committee decides which Republican lawmakers become ranking members on House committees.[5] Simpson replaced Congressman Don Young (R-AK) on the committee.[4]

Simpson is a member of the Republican Party. However, he is known to be pragmatic on certain issues. For example, he was one of a handful of Republicans to vote in favor of the reauthorization of the State Children's Health Insurance Program (SCHIP) in the 110th Congress.[11] Simpson has also been a supporter of the National Endowment of the Arts and the National Endowment of the Humanities, voting each year against Republican amendments to strip them of funding. In the past, he has opposed "earmarks", or congressionally directed spending.

When asked about the Grover Norquist pledge to oppose any net increase in taxes, Simpson said, "Well, first the pledge: I signed that in 1998 when I first ran. I didn't know I was signing a marriage agreement that would last forever."[14]

Simpson was one of the Members of Congress to sign the D.C. v. Heller amicus brief which supported a recognition of the Second Amendment as an individual right.[15] He voted for and helped to pass the "National Right-to-Carry Reciprocity Act of 2011".[16] Under this new law, which passed through the House of Representatives on November 16, 2011, people with a valid license are allowed to carry a concealed weapon in other states, as long as those states allow concealed weapons and don't have specific rules about concealed weapons carried by nonresidents.[17]

Simpson's hallmark legislation in the House of Representatives has been the Central Idaho Economic Development and Recreation Act (CIEDRA), which would create 312,000 acres of wilderness in central Idaho, much of which is currently a wilderness study area. Simpson has faced substantial resistance from groups like the Sierra Club who claim the bill lacks "wilderness values"[18] because the bill allows for motorized access to certain portions of the wilderness area and some land federal land would be transferred to the State of Idaho to promote the economic development of the local community and the recreational use of National Forest land and other public lands in central Idaho.[19] Simpson has also faced opposition from groups who oppose new federal land designations, and wilderness designations particularly because of restricted access to wilderness areas.[18] In August 2015 a revised version of CIEDRA, the Sawtooth National Recreation Area and Jerry Peak Wilderness Additions Act, passed Congress and was signed by President Obama, creating the Hemingway–Boulders, Jim McClure–Jerry Peak, and White Clouds wilderness areas, which cover a total of 275,665 acres (111,558 ha) of central Idaho.[20]

He also played a crucial role with the Ninth Circuit Court of Appeals Judgeship and Reorganization Act.[21] Mike Simpson's goal is to amend title 28, and create the appointment of additional Federal Circuit Judges, to divide the Ninth Judicial Circuit into two smaller judicial circuits.[22] The Ninth Circuit Court of Appeals Judgeship and Reorganization Act was introduced to House Judiciary Committee, and more specifically to the subcommittee on Courts and Competition Policy. Since Jan 24, 2011, the bill has been in the subcommittee, where it will be refined before being presented by to the Judiciary Committee, then later the actual House of Representatives.

Following the death of Congressman Charlie Norwood (R-GA) in February, 2007, Simpson has become a leading advocate of the American Dental Association (ADA) in Congress, in part because his profession is dentistry. The advocacy inspired Simpson to introduce legislation regarding methamphetamine, specifically how the drug affects tooth decay or "methmouth". The bill is formally called H.R. 1671: Meth Mouth Prevention and Community Recovery Act, with the purpose to understand and address the oral health problems associated with methamphetamine. The bill's goals are to expand and intensify the Department of Health and Human Services, make grants available to educate 12- to 17-year-olds about methmouth, and to promote a series of education activities for all dentists to learn about substance use disorders and their relationship to oral health and the provision of dental care.[23] As of March 24, 2009, the bill was put from the House Committee on Energy and Commerce to the Subcommittee on Health where it has been debated, but never brought to a conclusion. As soon as that happens, it will be brought up before the whole committee, then later the House of Representatives.[24]

Simpson is a strong supporter of the domestic sugar beet producers,[27] and the Idaho potato growers.[28] In 2010, Simpson took up the cause, alongside his former Democratic colleague, Walt Minnick, the lead sponsor of the bill, to secure a third federal judge for Idaho.[29] Simpson was quoted as saying, "The caseload of the Idaho District Court has increased significantly in recent decades resulting in Idaho’s district judges carrying a disproportionate share of cases in relation to their colleagues in other states."[29]

Simpson has become increasing opposed to President Obama and the Congressional Democrats' policy agenda. Simpson has announced his commitment to repealing the Patient Protection and Affordable Care Act, questioning its constitutionality and effectiveness.[30] He is close to and loyal to Speaker John Boehner.[31]

Esquire magazine listed Simpson as one of the 10 Best Members of Congress in October 2008.[38] The magazine said of Simpson, "More than any other representative, Simpson lives by the philosophy that democratic representation is a matter of finding not advantageous positions but common ground..."[38] The magazine's portrayal of Simpson echoes one of his personal philosophies, which is embodied in a quote by Henry Clay: "Politics is not about ideological purity or moral self-righteousness. It is about governing, and if a politician cannot compromise he cannot govern effectively." This quote is framed and hangs in Simpson's Washington D.C. office.[39]

While the Republican Party held the majority in the U.S. House of Representatives, Simpson often served as the Speaker Pro Tempore of the House, particularly during debates concerning controversial legislation, due to his command of House procedure. Simpson is known to have broken several sounding boards with the gavel while calling the House to order. This inspired Simpson to have a number of sounding boards produced in Idaho, which he presented to then Speaker of the House Dennis Hastert (R-IL) as a joke. When the Republican Party regained control of the House of Representatives in 2010, Mr. Simpson began once again to serve frequently as the Speaker Pro Tempore of the House.[41][42]

During the 2007 scandal involving Senator Larry Craig (R-ID), Simpson was openly considered for an appointment to the U.S. Senate in the event that Senator Craig resigned. Simpson, however, asked Governor C.L. "Butch" Otter to remove his name from consideration, claiming that the Idaho Congressional Delegation would be in a better position if he were to remain in the House and retain his seniority on the House Appropriations Committee.

Simpson rankled Senate leadership during the Craig scandal by criticizing them for their treatment of the Senator. Simpson is quoted as saying, "If that’s how they treat their own, that tells me they’re more interested in party than individuals, and the party is made up of individuals. How you treat them says a lot about your party."[53] Simpson is not known to have condoned Craig's alleged misconduct, but he demanded that Craig be treated fairly. For example, he is quoted as saying, "They have people over there [in the Senate Republican Conference] in far worse trouble that they haven’t said a thing about."[53]

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